Altered cord serum lipid levels associated with small for gestational age infants.

OBJECTIVE: To determine whether small for gestational age (SGA) infants show changes in lipid metabolism that could distinguish growth-restricted subpopulations. METHODS: Sera from the arterial cord blood from 38 SGA infants were analyzed for apolipoprotein A-I level, total lipid content, and distribution of those lipids as triglycerides, diglycerides, free fatty acids, and phospholipids. Comparisons were made between appropriate for gestational age (AGA) controls (n = 25), SGA infants with a ponderal index below the tenth percentile (SGA I, n = 20), and SGA infants with a ponderal index above the tenth percentile (SGA II, n = 18). RESULTS: Total cord serum lipid content was markedly decreased in all SGA infants compared with AGA infants (2.8 times lower). Although SGA infants showed total lipid concentration decreases, SGA I and SGA II infants showed distinct characteristics. Infants in the SGA I group had higher triglyceride levels (1.8 times higher) and lower free fatty acid levels (1.4 times lower), compared with AGA infants (P < .001). The lipid subclass distribution in SGA II infants was not significantly different from that in AGA infants, with the exception of an increase in triglyceride concentrations (1.3 times higher). Although the 22-kD placenta-derived apolipoprotein A-I was similar in all groups, the level of fetal liver-derived 28-kD apolipoprotein A-I was 6.5 times lower in SGA I infants than in AGA or SGA II infants (P < .001). CONCLUSION: The SGA I infants appeared to have impaired utilization of circulating triglycerides, consistent with peripheral adipose depletion. Diminished fetus-derived apolipoprotein A-I levels with normal levels of placenta-derived apolipoprotein A-I levels might indicate a defect in the production or secretion of apolipoproteins associated with growth restriction.

Inflammatory disease of the brain diagnosed by computed tomography.

Inflammatory disease of the brain, particularly of pyogenic etiology, may be most accurately assessed by the use of computed tomography and contrast enhancement. Examples of cerebritis, evolving and mature intracerebral abcesses, and inflammatory extracerebral collections are presented and discussed, particularly with reference to differential diagnosis and the problem of infectious versus neoplastic etiology. Ancillary studies, particulary selective arteriography, are reviewed where appropriate. The residual changes of inflammatory disease of the brain after medical and/or surgical therapy are illustrated, and the value of serial examinations is emphasized. The rural indigent patient population (American Indian) served by the University of New Mexico Medical Center is a source of case material providing several examples of severe and untreated intracerebral infectious processes heretofore not described in the literature.

Two cases of giant intracerebral aneurysm simulating neoplasm on ct scan; one with coexistent chronic subdural hematoma.

Two cases of giant intracerebral aneurysm are presented. Both exhibit increased absorption values in a circumferential configuration peripherally after the administration of contrast material. In addition, one case demonstrates a coexistent contralateral chronic subdural hematoma. No previous example of intracranial aneurysm exhibiting this configuration on computed tomography has been described in the literature. The operative, computed tomographic, radionuclide and angiographic findings are described and the differential diagnosis discussed.

Improved diabetes care in a UK health district.

The present study reports an analysis of diabetes care in general practice in a London Health District. A specialist nurse facilitator used various techniques to obtain practice information building up individual practice profiles. Four groups of constraints were identified as affecting the provision of GP diabetes care. Individual practice plans were formulated, working with key staff, to apply various interventions to ameliorate identified constraints. Using a non-prescriptive approach, GPs were encouraged to become involved in diabetes care in the way they felt most appropriate for their practice. Using this method, GP involvement in diabetes care has increased from 17 to 53% during the three years of the study.

Excision of zirconium iodide clusters from highly cross-linked solids.

Highly cross-linked cluster precursors KZr6I14B, Zr6I12B, KZr6I14C, and Zr6I12C were, successfully excised in deoxygenated water, and the resulting red aqueous solutions of clusters exhibit better kinetic stability with respect to decomposition than their chloride and bromide analogues. On traversing the Cl-->I series, NMR measurements show increasing deshielding of the interstitial atoms (Z = B, C) in Zr6ZX12 clusters and cyclic voltammetry reveals increasingly positive reduction potentials for the [(Zr6BX12)(H2O)6]+ ions. Several new cluster complexes have been crystallized from aqueous or methanolic solutions. Crystallographic data for these compounds are as follows: [(Zr6BI12)(H2O)6]Ix11.7(H2O) (1), triclinic, P1, a = 10.2858(7) A, b = 11.3045(8) A, c = 20.808(1) A, alpha = 77.592(1) degrees, beta = 79.084(1) degrees, gamma = 77.684(1) degrees, Z = 2; [(Zr6BI12)]+[I(CH3OH)6]- (2), hexagonal, R3, a = 17.706(1) A, c = 13.910(1) A, Z = 3, [(Zr6CI12)(H2O)6]I(2).4(H2O) (3), triclinic, P1, a = 10.1566(5) A, b = 10.4513(5) A, c = 10.7549(6) A, alpha = 117.552(1) degrees, beta = 96.443(1) degrees, gamma = 96.617(1) degrees, Z = 1.

Familial relative polycythaemia due to haemoglobin Heathrow.

Eleven affected members of a New Zealand family carrying the high oxygen affinity haemoglobin Heathrow are described. The detection of high oxygen affinity abnormal haemoglobins may be difficult as haemoglobin and red cell mass may both fall within the normal range and no abnormality may be detected on haemoglobin electrophoresis or by haemoglobin stability tests. The importance of oxygen affinity studies to establish the diagnosis is emphasized.